U.S. doctors reconsider Pfizer's Paxlovid for lower-risk COVID patients

By Deena Beasley

(Reuters) - Use of Pfizer Inc's COVID-19 antiviral Paxlovid spiked this week, but some doctors are reconsidering the pills for lower-risk patients after a U.S. public health agency warned that symptoms can recur after people complete a course of the drug, and that they should then isolate a second time.

More quarantine time "is not a crowd-pleaser," Dr. Sandra Kemmerly, an infectious disease specialist at Ochsner Health in New Orleans, told Reuters. "For those people who really aren't at risk ... I would recommend that they not take it."

Use of Pfizer's Paxlovid, authorized to treat newly infected, at-risk people in order to prevent severe illness, has soared as infections have risen. More than 162,000 courses were dispensed last week - compared with an average of 33,000 a week since the drug was launched late last year, according to government data. Biden administration officials have pushed for wide use of Paxlovid, which the government purchased and provides free.

But higher use has also come with more reports from people who say their symptoms eased with Paxlovid only to return a few days after finishing a five-day regimen of the pills.

On Tuesday, the Centers for Disease Control and Prevention, citing case reports and concerns that relapsed patients could spread the virus, issued its advisory that Paxlovid users should isolate for a second five days if symptoms rebound.

"I am shying away from giving it to people who are very low- risk, and are not terribly ill, particularly people who are vaccinated and boosted," said Dr. Bruce Farber, chief of public health and epidemiology for Northwell Health. He said he is still recommending Paxlovid for people who have significant health conditions or are over age 75.

Pfizer, in an email, said it is monitoring the data, but believes the return of detectable virus is uncommon and not uniquely associated with its drug. "We have not seen any resistance emerge to date in patients treated with Paxlovid," a spokesperson said.

Paxlovid's emergency authorization stipulates that it should be used only for newly infected people with risk factors, but doctors said many others have sought out a prescription.